Provider Demographics
NPI:1285238345
Name:LENZ, JENNIFER KAY (RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:LENZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 BROOK MILL CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9101
Mailing Address - Country:US
Mailing Address - Phone:317-816-0310
Mailing Address - Fax:
Practice Address - Street 1:10580 E 96TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9643
Practice Address - Country:US
Practice Address - Phone:317-849-6406
Practice Address - Fax:317-849-6456
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018290A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty